Cost-Effectiveness and Challenges of Implementing Intensive Blood Pressure Goals and Team-Based Care

Curr Hypertens Rep. 2019 Nov 7;21(12):91. doi: 10.1007/s11906-019-0996-x.


Purpose of review: Review the effectiveness, cost-effectiveness, and implementation challenges of intensive blood pressure (BP) control and team-based care initiatives.

Recent findings: Intensive BP control is an effective and cost-effective intervention; yet, implementation in routine clinical practice is challenging. Several models of team-based care for hypertension management have been shown to be more effective than usual care to control BP. Additional research is needed to determine the cost-effectiveness of team-based care models relative to one another and as they relate to implementing intensive BP goals. As a focus of healthcare shifts to value (i.e., cost, effectiveness, and patient preferences), formal cost-effectiveness analyses will inform which team-based initiatives hold the highest value in different healthcare settings with different populations and needs. Several challenges, including clinical inertia, financial investment, and billing restrictions for pharmacist-delivered services, will need to be addressed in order to improve public health through intensive BP control and team-based care.

Keywords: Blood pressure; Cost-effectiveness; Hypertension; Nurses; Patient care team; Pharmacists.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Antihypertensive Agents / economics
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Cost-Benefit Analysis
  • Goals
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / economics
  • Patient Care Team
  • Randomized Controlled Trials as Topic
  • Risk Factors


  • Antihypertensive Agents